Department of General Surgery, Ponderas Academic Hospital, Bucharest, Romania;
Rom J Morphol Embryol. 2021 Jul-Sep;62(3):671-678. doi: 10.47162/RJME.62.3.03.
Over the past decades, pancreatic ductal adenocarcinoma (PDAC) has been coming into view due to increased mortality, the 5-year survival rate being the lowest of all cancers (around 6%). In PDAC, microenvironmental components possess prognostic relevance. The aim of this article is to perform a review of studies evaluating the composition of the tumor microenvironment to identify tumor microenvironment-related prognostic biomarkers in patients with PDAC. A literature search has been performed in three major databases PubMed®, Embase®, Web of Science® using the search terms: pancreatic adenocarcinoma in combination with one of the following: alpha-smooth muscle actin (α-SMA), collagen I, cluster of differentiation (CD)31, CD105, CD3-CD4-CD8, CD68 and CD206. Total number of articles identified through database searching was 1185. After title and abstract review, we have selected 92 articles in which the markers sought were studied. Tumor microenvironment-related biomarkers appear to also possess role in monitoring the response to treatment. Thus, CD105 angiogenetic immunomarker, stromal immunomarkers such as α-SMA and collagen I, immune cells markers represented by CD4∕CD8 ratio, CD206 and CD68 were correlated with negative prognosis, while CD3+, CD8+ immune cells markers and CD31 angiogenetic immunomarker proved to be correlated with good prognosis. Furthermore, most studies were performed on resected specimens and culture cells, while only a few studies used specimens obtained through endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). To increase the therapeutic response and reduce toxicity, prognostic targets should be determined on a large scale, not only based on resected specimens. EUS-FNB represents a feasible method to provide sufficient tissue for diagnosis and additional immunohistochemistry analysis.
在过去的几十年中，由于死亡率的增加，胰腺导管腺癌（PDAC）逐渐受到关注，其 5 年生存率是所有癌症中最低的（约为 6%）。在 PDAC 中，微环境成分具有预后相关性。本文的目的是对评估肿瘤微环境组成的研究进行综述，以确定 PDAC 患者与肿瘤微环境相关的预后生物标志物。在三个主要数据库 PubMed®、Embase®和 Web of Science®中使用以下搜索词进行了文献检索：胰腺腺癌与以下之一的组合：α-平滑肌肌动蛋白（α-SMA）、I 型胶原、分化群（CD）31、CD105、CD3-CD4-CD8、CD68 和 CD206。通过数据库搜索确定的文章总数为 1185 篇。经过标题和摘要审查，我们选择了 92 篇研究了标志物的文章。肿瘤微环境相关的生物标志物似乎也在监测治疗反应方面发挥作用。因此，CD105 血管生成免疫标志物、基质免疫标志物如 α-SMA 和 I 型胶原、以 CD4∕CD8 比值、CD206 和 CD68 代表的免疫细胞标志物与不良预后相关，而 CD3+、CD8+免疫细胞标志物和 CD31 血管生成免疫标志物则与良好预后相关。此外，大多数研究都是在切除标本和培养细胞上进行的，而只有少数研究使用了通过内镜超声引导下细针活检（EUS-FNB）获得的标本。为了提高治疗反应并降低毒性，应该在更大范围内确定预后靶点，而不仅仅基于切除标本。EUS-FNB 是一种可行的方法，可以提供足够的组织进行诊断和额外的免疫组织化学分析。
